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Epidemiologic Notes and Reports Measles on a College Campus -- Ohio

Between January 15, and February 9, 1985, 12 confirmed cases of measles among students at The Ohio State University have been reported to the Ohio Department of Health. Two cases have been serologically confirmed. The index case is a senior student who acquired measles while traveling to London and Sierra Leone between December 8, 1984, and January 5, 1985. His rash onset was January 15; he subsequently infected four additional students. To date, students in one fraternity, one sorority, and three dormitories have been infected. In addition, several students in a brother fraternity at neighboring Miami University of Ohio have been exposed to a potentially infectious student from The Ohio State University.

The student health service, assisted by the Ohio Department of Health, has initiated several control measures, which include: (1) holding voluntary vaccination clinics in affected dormitories and at the student health clinic; (2) publicizing the outbreak on campus and in the surrounding community; and (3) increasing surveillance on campus and in the surrounding community. To date, 500 doses of vaccine have been administered to the student body, which consists of approximately 50,000 students. Additional clinics are planned for fraternity and sorority members. Reported by DI Charles, MD, Director of Student Health Svcs, FW Smith, MD, Chief of Preventive Medicine, RJ Spillman, PhD, Vice Provost for Student Affairs, The Ohio State University, Columbus, TJ Halpin, MD, State Epidemiologist, Ohio Dept of Health; Div of Immunization, Center for Prevention Svcs, CDC.

Editorial Note

Editorial Note: Measles outbreaks on college campuses have been reported with increasing frequency in recent years (1). In 1980, 1.5% of all reported cases occurred on college campuses, compared with 19.8% of all cases reported in 1983. In 1984, one large outbreak in New Hampshire involved 29 students or their family contacts at Dartmouth College, the community, and patients and staff at the community hospital (2). The current outbreak has already involved three generations, and additional spread seems likely.

The propensity of measles to spread among college students is related to several factors, the most important of which include: (1) many college-aged students may have missed measles vaccination in the first years following licensure of measles vaccine; (2) college students tend to congregate in large groups (e.g., dormitories, fraternities and sororities, and social and sporting events); and (3) many colleges and universities lack immunization requirements. Since approximately 5%-15% of college-aged individuals are currently susceptible to measles when tested serologically (4), college campuses effectively become a gathering place where large pools of susceptibles congregate. Any introduction of measles virus is likely to spread easily in such a susceptible population.

Measles outbreaks on college campuses are costly and disruptive. It is estimated that the Dartmouth outbreak cost over $30,000 to control (2). The direct costs of controlling the 1983 outbreak at Indiana University at Bloomington exceeded $225,000 (1).

Because it is more cost-effective to prevent measles outbreaks than to attempt to control them (1), in May 1983, the American College Health Association adopted a preadmission immunization policy recommending that, by September 1985, colleges and universities require all students born after 1956 to present documentation of immunity to measles and other vaccine-preventable diseases before matriculation. A similar recommendation was made in 1980 by the Immunization Practices Advisory Committee (5). Several universities have already implemented such policies. In Mississippi, students registering for the first time at state-supported 4-year colleges and universities are required to furnish proof of immunity to measles and rubella. Currently, neither The Ohio State University nor the other affected colleges in Ohio have immunization requirements for matriculating students.

References

  1. CDC. Measles outbreaks on university campuses--Indiana, Ohio, Texas. MMWR 1983;32:193-5.

  2. CDC. Measles--New Hampshire. MMWR 1984;33:549-54, 559.

  3. Bart KJ, Stenhouse DH. Measles and rubella on college campuses: the need to act. J Am College Health 1983;32:58-62.

  4. Amler RW, Kim-Farley RJ, Orenstein WA, Doster SW, Bart KJ. Measles on campus. J Am College Health 1983;32:53-7.

  5. CDC. Rubella--United States, 1977-1980. MMWR 1980;29:378-80.



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